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Billing & Coding, Getting it Right with EHR

The complexity of billing and coding encompasses all spheres of medical specialties, however tops that list. The associated interventions to patients, invasive procedures, and blood infusions add to the complexity of the specialty needing extreme deftness in billing and coding all aspects of the service.

billing and coding is contingent on billers and coders to have an excellent working knowledge of current coding rules, specific codes, and compliance standards. Inaccuracies in billing and coding can adversely affect the revenue cycle of the specialty.

BillingParadise has a long partnering experience with specialties using EHR and practice management software. Our experienced team of certified billers and coders has efficiently fulfilled their billing and coding needs.

Best Plan Approach for Billing and Coding

We assign extensively experienced certified coding professionals for billing operations. They log into the EHR of the practices to access physician office and operative notes, based on which accurate ICD-10-CM, CPT, HCPCS Level ll, and modifier codes are applied. After completion, the claims are electronically sent to the payers for reimbursements

Integration of RCM tools with

We can also integrate our proprietary automation RCM tools with the EHR. The reporting and analytic tools are valuable for end-to-end RCM operations.

Our billers have an in-depth knowledge of rules and regulations applied to Medicare billing. Be it for heart catheterization, coronary interventions, pacemakers, or peripheral vascular procedures, our coders with years of experience have been efficiently fulfilling the billing needs of practices.

In order to improve the revenue earnings of a practice, minimizing claim denials is the very first step. As a billing company, we constantly stay updated on any changes in billing and coding.

Our best plan approach for billing and coding includes:

Documentation Accuracy -

Accuracy of documentation has a great impact on the revenue cycle of a practice. Coding for cardiac procedures needs alertness, especially when it comes to cardiac catheterizations, inconsistencies in documentations may result in loss of components that potentially could be coded. Standard cardiac procedures may need additional procedures to be performed, this need to be well-documented.

Comorbidity Inclusions -

Costs play a significant part in a patient’s health status, other than the outcomes. Higher reimbursements result in patients with specific diagnosis along with comorbid conditions. The complexity of the case can be highlighted by including diagnosis codes for relevant comorbidities documented by the physician. As an example, our billing team have come across situations where a cardiologist would be treating congestive heart failure in a patient, additionally treatment for arthritis, COPD, and anemia were planned for the patient, because these were well documented by the physician, our billers and coders factored them into the treatment, which facilitated a higher reimbursement for the provider, after the payer was made aware of the estimated cost.

Emphasis More on Diagnosis than Symptom Coding-

Depending on the availability of a confirmed diagnosis for a patient, we generally avoid using symptoms code. No additional codes for symptoms associated with a disease are used, unless specific instructions are available for using them. The ICD-10 official guidelines spell out that symptom not usually associated with a disease may be reported.

Combination Codes

conditions are defined with a few combination codes in ICD-10. Our billers and coders make use of these codes wherever they are appropriate. We also diligently follow a code’s instructions to “use additional code,” “code also,” or “code first”, ensuring that complete details are projected in the claims.

How Outsourcing Billing and Coding Can Benefit Your Practices Using EHR

The multiple procedural rules, complex contractual adjustments, and codes that regularly change, make coding and billing a time consuming cumbersome task. The most challenging aspect of billing and coding is assigning CPT code, especially when modifiers have been used.

It requires a lot of time and effort staying updated with new codes, code revisions, and deleted codes. Inconsistencies in billing and coding can be detrimental for the growth of a health organization, at the same time it can adversely impact patient care.

Billing, Coding and Reimbursement Capabilities

BillingParadise with long years of billing, coding and reimbursement practices can be a valuable partner in the revenue success of your organization. Our certified medical billers have the requisite skills in all aspects of revenue cycle.

The RCM team’s expertise in understanding the nuances of payer requirements and reimbursements, especially in the realm of billing and coding has benefited several specialties improve their cash flow and revenue cycle. Our medical billing and reimbursement specialist efficient manage claim submissions in accordance with government regulations and private payer policies. We also diligently follow-up on claim statuses, resolve claim denials, and submit appeals. Additionally, we also post payments, and adjustments, and manage collections

Hiring Billers & Coders

If your organization is concerned about privacy issues that may be compromised if billing and coding operations are sourced from third parties, you can choose the hiring option. Certified billers and coders will be assigned to your organization, they will report to your in-house billing team, and fulfill your in-house billing and coding needs. The can be hired for end-to-end RCM operations or A/R and Denial Management.

6 RCM tools all group practices should use

Your all-you-need-to-know guide for improving revenue

We've got you covered

Transitioning from the tried and tested fee for services model to the riskier (though more rewarding) value based payment environment can be tough on group practices. Bundled payments provide a middle path that makes the journey less stressful. The risk and rewards are arguably, the highest for practices. But bundled payments add more complexity to the billing and collections process and this is one reason why healthcare organizations are wary to adopt this model.
You need a trusted partner to make the leap. And we are one for several group practices based in California, Texas and New Jersey.

A powerful tool to help you thrive in a bundled payment arrangement

The Physician Productivity Metrics Tracker tool will enable group practices to view the individual productivity scorecard, work RVUs, productivity metrics, charges, collections, productivity ratio and more, of physicians.
Track and analyse a detailed scorecard of individual physicians in under 2 clicks. We put the power of accurate data in your hands so taking decisions and apportioning payments is no longer an irksome task.

We help you adapt to the consumer driven healthcare marketplace of today

In the current healthcare landscape it is important to simultaneously increase patient collections as well as patient engagement. At BillingParadise we help you strike the perfect balance between both.

Key benefits of our patient billing services

We offer patient billing at client-selected cycles

Our patient statements are clear, prompt and help better the patient payment experience

We efficiently manage the pre-authorization and medical necessity requirements of your medical group

Our automatically generated ABNs reduce denials and claims rework

To know more about our patient billing services click here

Monitor vital patient payment metrics effortlessly

To survive in the patient centred healthcare marketplace you to monitor and analyse enormous amounts of patient payment data. Instead of assimilating layers of information BillingParadise helps group practices to trim the fat and view the details that matter.

Adopting or replacing an EHR will have far-reaching implications in the revenue cycle of a healthcare organization. To avoid financial risks and temporary setbacks in revenue work with our revenue management experts. With right strategies, teams and technology we help you transform a tough challenge into an opportunity for growth. We recommend revenue cycle best practices to maintain revenue cycle performance during the strenuous adoption/migration stage.

At BillingParadise we love working with EHRs. We work with Allscripts, NextGen, eClinicalWorks, eMDs, Amazing Charts, Greenway, Cerner and several other major EHR and practice management systems every day. To know more about our EHR billing services for group practices click here.

The backbone of all healthcare data is claims data. Tracking key revenue cycle performance metrics is essential to make process improvements and identify revenue leaks. A recent survey reveals that the top challenge faced by healthcare CFOS is tracking RCM metrics. Here’s finally a tool that gets it right.

theBillingBridge is a free revenue cycle reporting tool that will enable your group practice to track revenue cycle metrics, view detailed collection reports, understand your claims cycle better and offer you full visibility of your RCM processes. It is built to work in the Smartphone environment and is available on both Android and iOS platforms.

It is integrated with several major PMS, EMRs and EHRs like Kareo. Data that is captured in your PMS is instantly available on theBillingBridge because it is seamlessly integrated with the system you use.

With theBillingBridge you can:

View your claims journey in realtime

Track insurer and patient payment reports separately

Schedule appointments quickly

Know the productivity scorecard of providers

Categorize and manage denials

Know your top paying CPTs and insurance companies

Communicate with your billing team within theBillingBridge

And a host of other secure, HIPAA compliant, customizable features! Sounds good? Please ask for a free demo of theBillingBridge to know why you should download it.

Testimonials

Well. The proof is in the pudding

"I feel like my practice has made a great comeback. From dipping into my pocket to pay staff to running a successful practice once again, this feels like a dream. Thanks to your team" was an email we received from Glen the other day. It certainly feels like a dream run, for us too!"

- Jason, Owner and CEO

" After 90 days period, we have presented the denial report to Dr. Mona, like a clean slate with about 98.4% denials effectively managed. Dr. Mona was amazed and said, “It is incredible for me that my practice has achieved such a high reimbursement and you really jumped into the play like a knight in shining armor. Thank You BillingParadise!” "

We offer RCM services for...

Cardiac Surgery

Pediatric

Neurosurgery

Sports Medicine

Interventional

Chiropractic

Rheumatology

Obstetric

We offer RCM services for...

Cardiac Surgery

Pediatric

Neurosurgery

Sports Medicine

CInterventional

Chiropractic

Rheumatology

Obstetric

Specialized Support

An answer for your every need

Billing & Collections

Do you want a powerful for your billing aches? BillingParadise is your answer. Our billing experts can up your collections ratio and decrease workflow hassles. And the best aspect of working with us is that we have a solution for every concern of yours.

EMR Support

Contain costs with our EHR/EMR billing support. Missed dinner again?Most users complain that an EHR adds to the number of hours they work. We bill and process claims within your EHR system so you can get back home early. And spend less time worrying about,whether you fed your system with the right billing information.

Coding

Most practices struggle with revenue loss after a compliance update. At BillingParadise we minimize regulatory pressures by staying on top of evolving regulations and ensuring that your practice is completely compliant. Mitigate the risk of non-compliance and eliminate audit risks.

Old AR

BillingParadise's stand alone old AR clean up / recovery service will let you submit accurate & error free claims. Which means our dedicated AR management team will follow up with your old unpaid claims. We will assign you a dedicated insurance specific calling team who knows the language of your payer. Our AR callers are specific, trained and certified professionals.

Specialized Support

An answer for your every need

+

Billing & Collections

Do you want a powerful for your billing aches? BillingParadise is your answer. Our billing experts can up your collections ratio and decrease workflow hassles. And the best aspect of working with us is that we have a solution for every concern of yours.

+

Coding

Most practices struggle with revenue loss after a compliance update. At BillingParadise we minimize regulatory pressures by staying on top of evolving regulations and ensuring that your practice is completely compliant. Mitigate the risk of non-compliance and eliminate audit risks.

+

EMR Support

Contain costs with our EHR/EMR billing support. Missed dinner again?Most users complain that an EHR adds to the number of hours they work. We bill and process claims within your EHR system so you can get back home early. And spend less time worrying about,whether you fed your system with the right billing information.

+

Old AR

BillingParadise's stand alone old AR clean up / recovery service will let you submit accurate & error free claims. Which means our dedicated AR management team will follow up with your old unpaid claims. We will assign you a dedicated insurance specific calling team who knows the language of your payer. Our AR callers are specific, trained and certified professionals.